Int Arch Otorhinolaryngol 2014; 18(02): 217-220
DOI: 10.1055/s-0033-1351676
Case Report
Thieme Publicações Ltda Rio de Janeiro, Brazil

Synchronous Bilateral Warthin Tumors: A Case Report

Luiz Augusto Nascimento
1  Department of Otolaryngology Head and Neck Surgery, Hospital Universitário de Brasília (UnB), Brasília/DF, Brazil
,
Julia Alessandra Santos Ferreira
2  Student, Department of Medicine, Universidade Católica de Brasília, Brasília/DF, Brazil
,
Raquel Baptista Pio
2  Student, Department of Medicine, Universidade Católica de Brasília, Brasília/DF, Brazil
,
Gustavo Henrique Soares Takano
3  Master Degree, Department of Medical Pathology, Hospital Universitário de Brasília, Brasília/DF, Brazil
,
Hélcio Luiz Miziara
4  Doctor Degree, Department of Medical Pathology, Universidade Católica de Brasília, Brasília/DF, Brazil
› Author Affiliations
Further Information

Publication History

24 October 2012

18 February 2013

Publication Date:
05 November 2013 (online)

  

Abstract

Introduction Warthin tumor is described as papillary cystadenoma lymphomatosum and is the second most common tumor of the parotid glands. Bilateral synchronous incidence is rare, occurring in 7 to 10% of the cases. It is more common in males between 60 and 70 years of age and is closely related to smoking. There is slow growth and the condition is a delimited nodule of regular outlines; it has low rates of malignant progression and recurrence.

Objective Report a case of synchronous bilateral Warthin tumor occurring in an elderly patient, and review incidence and peculiarities of this tumor.

Case Report A 78-year-old man who used to smoke had a history of mild pain in the topography of right parotid three weeks ago. Patient with hypertension, diabetes and a longtime smoker (smoking a pack per day for 32 years) noticed a progressive bulging in the right parotid region for about 2.5 years ago, and noticed another progressive bulging (althought in the left parotid region), for about one year ago. Patient denied fever, redness, skin lesions and pain during this period until last three weeks, when he sought medical attention for a mild pain in the right facial region. The patient underwent cervical magnetic resonance imaging that showed tumor lesions in both parotids. Fine needle aspiration revealed a typical lesion of epithelial oxyphilic cells associated with reactive lymphoid proliferation, suggesting Warthin tumor. The patient underwent two superficial parotidectomies, and the histopathologic result from both tumors of parotid glands showed papillary cystadenoma lymphomatosum.

Conclusion The occurrence of synchronous bilateral Warthin tumor is extremely rare, and anamnesis and physical examination, as well as some complementary examinations, are important means for diagnostic evaluation. Confirmation of the diagnosis can only be obtained through a histopathologic study. A superficial or total parotidectomy is the recommended treatment for the disease.